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Discussion

frequent vomiting, any ideas?

Okay fellow school nurses, I have an awesome 5th grade kid who has been out of school for going on 2 weeks (9 days so far) for vomiting. He's a high anxiety type of kid, but hasn't had anxiety related absences or nurse visits since 3rd grade. He hung out in my office a few days ago while mom had a meeting with his teachers about sending his work home, in the hour he was with me, he vomited 6 times.

Mom is feeling like her concerns aren't being heard by his pediatrician-no tests have been ordered, no anti-nausea medication. When he became very dizzy over the weekend, she took him to the ER and they did labs and dx with dehydration r/t psychosomatic emesis. I sent him home today because he was vomiting and urged mom to seek an opinion from GI. Even if it is anxiety related, a kid can't just keep vomiting for days on end without negative health effects, right? Feeling a bit helpless with this one, any ideas?

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    I had a student who had this problem, though not to the same extent. He was eventually able to come to school with far less vomiting. I think we kept Zofran in the office too. But it sounds like your student is much more severe.

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    May be premature, but it could be "abdominal migraines". These kids can vomit 20 times daily. It is often seen as psychosomatic. Prescribing Imitrex is a way to rule it out. Anxiety is a common symptom.

    What is CVS? | CVSA

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    • Author
    May be premature, but it could be "abdominal migraines". These kids can vomit 20 times daily. It is often seen as psychosomatic. Prescribing Imitrex is a way to rule it out. Anxiety is a common symptom.

    What is CVS? | CVSA

    I mentioned cyclical vomiting syndrome to mom, I only knew about it because my best friend in middle school had it. I'm really hoping she bypasses the pediatrician and gets him seen by someone more willing to investigate.

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    My son's best friend, a former student, has it, as well as her brother. Sad. Hopeful they will grow out of it.

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    I Had a student that did this often, mom finally took child to a specialist and diagnosed her with Cyclic Vomiting Syndrome. We had a supply of Zofran for her in my office - the only problem with the zofran was that it made her sleepy - the kid would fall asleep for 1-3 hours after taking it.

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    I also had a student with frequent vomiting one year - poor thing threw up three times a school day on average (and was so embarrassed and exhausted). I also ended up with Zofran in my office. Luckily, the student did grow out of it.

    OP, I think you're doing what you can. Do you have permission to talk with the student's pediatrician? If so, maybe you should call and let them know what you are seeing. A confirmation from another health care professional may help this student get the referral they need.

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    • Experts
    May be premature, but it could be "abdominal migraines". These kids can vomit 20 times daily. It is often seen as psychosomatic. Prescribing Imitrex is a way to rule it out. Anxiety is a common symptom.

    What is CVS? | CVSA

    Thank You... always learn something new reading the school nurses forum.

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    I'm so sorry for that poor kid. I think encouraging mom to seek a specialist is a good idea if she is able to bypass the pedi completely. Also, if he does have anxiety, too (which I would if I was vomiting that much) maybe talking to mom about seeing a therapist, too. Go after any issues from both sides.

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    May be premature, but it could be "abdominal migraines". These kids can vomit 20 times daily. It is often seen as psychosomatic. Prescribing Imitrex is a way to rule it out. Anxiety is a common symptom.

    What is CVS? | CVSA

    Just learned something new. Hopefully they can figure out what's wrong with the student soon, I'd hate to see him get hospitalized with electrolyte imbalances and dehydration.

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    • Author

    Thank you everyone! He's been out all week again. I'm really hoping to hear from mom today after his dr. appt.

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    Praying they find him relief.

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    Not a school nurse, but from my experience: If the pediatrician is still dicking around with this kid, mom needs to go park in the ED of the nearest children's hospital until she gets a GI referral/ consult.

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